MEDICARE: ANA M GUZMAN LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1497279723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA M GUZMAN LPC

Provider Business Mailing Address
First Line	:	1151 N BUCKNER BLVD STE 107
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3438
Country	:	US
Telephone Number	:	214-771-8852
Fax Number	:

Provider Business Practice Location Address
First Line	:	1151 N BUCKNER BLVD STE 107
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3438
Country	:	US
Telephone Number	:	214-771-8852
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2017
Last Update Date	:	12/16/2021

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